Publication:

Correlation of functional results of caudal epidural steroid injections with duration of symptoms in PIVD

Background Low backache and sciatica is a common complaint signifying some underlying pathology; it may be a soft tissue strain or disc protrusion, or conditions such as neoplasm or ankylosing spondylitis besides others. We aim to assess the functional outcome of epidural steroid injection in patients with low backache and sciatica as well as the effect of pre operative duration of symptoms in Indian population presenting to our centre, on the post procedure outcome, if any.

Methods 50 patients were evaluated with complaints of low backache and radiculopathy. They were subjected to following questionnaires including the ODI and VAS, and the scores were evaluated before and after the intervention, and at every follow up.

Results Patients commonly affected were from 4th and 5th decade. The commonest intervertebral disc involved was L4-5 (44%) followed by L5-S1 (30%). Significant Functional status improvement according to ODI scoring was observed in all follow up visits. Similarly significant reduction in pain intensity according to VAS scoring was observed in all follow up visits. On comparing the improvement in functional status (ODI) and pain (VAS) between the 3 groups, it is seen that patients in group A had the highest rate of improvement, while patients in group C had the least improvement.

Conclusions Caudal epidural injections are safe, effective and less expensive modality of treatment without any significant complications. The lesser the duration of symptoms i.e. earlier the patient presents, better are the results with caudal epidural injection.